In recent years, in addition to the effect of regulation of calcium and phosphorus metabolism, the protective effect of serum vitamin D on the central nervous system has also attracted increasing attention. It is found that serum vitamin D deficiency is closely related to the occurrence of cerebral small vessel disease (CSVD) and the occurrence and development of cognitive dysfunction related to CSVD. This review will discuss the influence of serum vitamin D on CSVD from three aspects: risk factors, imaging findings and clinical symptoms, and provide basis for early prevention and intervention of CSVD.